HomeMy WebLinkAboutAPPLICATIONS, CO, MULT DOCS - 12-00152 - 565 Pioneer Rd - Rockcreek Townhome #124,i\r-
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Certificate of Occupancy
City of Rexburg
Department of Com munity Development
35 N. 1st E. / Rexburg, lD- 83440
Phone (208) 359-3020 lFax (208) 359-3022
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Gonstruction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
12 0A152
lnternational Building Code 2009
565 Pioneer Road, #124
Single Family Residential
Type V, non-rated
N/A
No
Rock Creek Hollow Llc
504 N 4000 E
Rigby, lD 83442
Northern States Development lncContractor:
Special Conditions:
Occupancy:Residential - 2 units or less, permanent in nature
This Certificate, issued pursuant to the requirements of Section 109 of the lnternational Building
Code, certifies that, at the time of issuance, this building or that portion of the building that was
inspected on the date listed was found to be in compliance with the requirements of the code for
the group and division of occupancy and the use for which the proposed occupancy was
classified.
Date G.O. lssued:/z
G.O lssued by:
There shall be no further change in the existing occupancy classification of the building nor shall any structural changes,
modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and
approved said future changes.
Plumbing Inspector:Fire fnspect or, ft /a-
Electrical Inspector:P&Z Administrator
Building Official
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Please Complete the Entire Application!
If the question does not apply fill in NA for non apptcable
-('We witl provide this For you)g,aSctL
UNIT# BLOCK#T" LOT#
rD 83440
PARCEL NU
SUBDIVISION:
35 N 1" E, REXBURG,
2AB-372-2326
ing is based on the information - must be accurate /.4-: ,4\ {-.iL} {-r{f&Y
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OWIERNAME:
PROPERTY ADDRESS, StS .b;>,.p* o ? ^*-i,
PHONE #: Home A6$' ?sti-Ltl5 L Work @to$ - t;t -1.\FY cen 1 ) Jpx-;r?d - BC, )ct
O\X/NER MAILING ADDRESS : Q /i. C,coinICITY: fkllq*r\ STATE:fb ZIP:SEqSt{
APPLICANT INFORMATION:
(If other than owner)
r, a statement authorizing applicant to act as
#: Home (
gj_27 (a
How many buildings are locared on this properry?
Did you recently purchase this property(SCles (If yes, Iisr previous owner,s name)
Is this " tot ,plit4{o) YES (please bring copy of new legal description of properry)
PROPOSED USE: _ z-s----\
(i'e'' Single Family ResidencefMulti FamilyJ Apartments, Remodel, Gatage,Commercial, Addition, Etc.) - CIRCr F.. ONE
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenartyorperfury.rherebycenirythatrhave read this application md state that the infomation herein is correct and I swer that my infomation which may hereafter be gven by me in hearings before the
:,jffi3#3.'-1fl:5",ilff#:.::*-?'?"i,:s.',i.3:'5:::"::-lr:,.:j9^**':,y:f'.1:. ;;;::' r, ,c*?'.ffi i* "u ci,v regu,ations and s,ate ,aws reratingto the subiect matter of this application md hereby authorized representatives of the city to enter up." ,rr. .uJ*-.r,i."Tip;;;7;rilffi;j;::::'ffi#It
*:r3ffi:lt:'3 ::f:""-::t^.,g::,1p::""1 1':::1::9i: ":,0."":sions
or the.2003 Intemational.Cod. - .",., oi"Ty rase statement or misrepresmtarion or ract
"'""yof"nwhichthepemitorapprovalwasbased. PemitvoidifnotstartedwithinlB0days. pemitvoid;fwort ,1oi'ii:'t"ffiffi:
/(-rt---'-- ? \(2- r3 r )Y /JLOwner/Applicant DATEprefer to be contacted by fax, email or phone? Circle One
WARNING - BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!Pl6 fees ate non-tetundable and arc paid in frrll at the time of application be gimitg ltaptry L 2mSCity of Rexburg's Acceptance of the plu review fee does not colsrituie plu ippro uA
- -
**Building Pemit Fees are due .r dme of applicariia*+ **gr;14;o, Pemite ate void if you clieck doee nor clear**
MAILING ADDRESS. IWfrCE-q_" -STATE}'}-ZI
PHONE: Cell#^XX-Fax#,]S8 -95? -q&3 [
IDAHO REGISTRATION # & EXP. DATE
Business Appficotion cl'l'\'oF
35 North lst Eost
Rexburg, lD 83440 Phone: 208.359.3(EO
Fox: 208.359.3022
Please take the time to answer all questions so that we can further assist you and your facility Thank you.
What tlpe of business will be performed
Will the business have food preparations?
Will there be any cooking of foods?
Will there be any deep fat frying?
Will you have food disposal on site?
will there be any maintenance or mechanical work in the building?
Will there be sumps or floor drains in the facility?
Will the business require more parking?
Will the business have any chemicals on site?
Is this business occupying an existing building?
Will the business be doing any structural/or remodeling changes to the building?
Any changes to the electrical?
Any changes to the plumbing?
Is this business planned to be the same with different ownership?
Will there be a change of occupancy?
Yes
Yes
No
No
Yes No
Yes
Yes
No
Yes
Yes
No
Yes No
No
No
NoYes
NoYes
Yes No
Yes
Yes
No
No
Yes No
Applicants Signature Phone DateI Certifu that The information that I have provided above is to the best ofmy knowledge accurate and trua
Bu
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35N tsf F
Rexburg, lD 83440 www.texburg.org
City of Rexburg
Phone: 2A8372.2326
Fox: 208.359.3022
Remode/z'ng fozntzziUng/Eome (need total constructions estimate, excluding fire,
electrical, plumbing, and Mechanical valuations) $
REXBIIRG'' (\r'
A fi e r i ca's Fatni ly Co nnn u n ii tt
ReszVentzh/
Fcr tlnrsSURFACE SQUARE uoofifu,t#$t hde the eneriorwall meas'rements of the building)
Fint FloorArea 1906 Unfinished Basemenr area
Second floor/loftarea finished basement areaThird floor/loftarea
Shed orBarn
Gange areaGarage "f" , tct g,lO
Caryor/ Deck (30' above grade)ry
CommerczT/
C-onstruction Type:OccupanryType:
SURFACE SQUARE FOOTAGE: (Shall include the exteriorwall measurements of the building)
New Construction sq. ft.
Commercial Remodel sq. ft,
C.ommercial Addition sq. ft.
Utility, Misc. Private Garage sq. ft.
Storage sq. ft.
Mz/a-Vamz7y/Sng/eStzdentr7ozsz'zg,
sq. ft. per unit
}\4anager Unit sq. ft.
Buifng Sofety Deportmerl arf\,'o'
City of Rexburg35 N. 1$ E., Rexburg,Id 83440
Phone -(208)3s9-3020 / Hotline -(208)372-2344 / Fax -eOg)3594A22
OVAIER.S NAME
PROPERTYADDRE
SLJBDIVISION ?,,--_,L._.r..-j=-i.t \lo._,> L.L<._PFTASE LOT___>_ Brocn
Permit# | L
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Electrical c-onrractor's *"-. #/r -, , #{;l Business Name //e l/-,..., , l<.r.r.i " -
address?. D. F.-* l9 )t Gry-le-a:r-".-State-3!Er--zipE3:r31
C:llPhoneFaH -lqo - ="t>\ gusinessphoneOog DSr-.?:r.i
FoQE)r)s"r - Lr)!\r Email
(COMMERCIAL/IND{JSTRIAL) Total costof electrical system (ContracredAmount)
(Inchdes the co$ oJ naterials ilstalled regardless of rhe part MPpbntS it Tlte fees listed uider tbis ;nEut;on jpe thall appjt to ofiod oiTE t irolnot specifcal! mentioned elswhere on thisforn).
! Up to $10,000 (total cost of slntem x 0.02) + 60 : $
tr Between $10,001- $100,000 ( (total cost of slstem - 10.000) x 0.01) + $260 : $! over 9100,001 ( (tgtal cost of slstem - 100.00b) x o.obs) + $1,160 : $Small Vor{<s (Contractors ONLY): $10 fee forworknot e*ceeding-$2OO incost and not involving a change in
service connections. Does NOT require inspection.
RESIDENTIAL
tVerz:-.fng/e Fami/y'Dwe//tng, thc/zdz'zg a//bzi/dzngs zaztb aznVzg bez'zg cozstructedon eaclpropenlt (,lBasedoz /zzzzg,?ace,see defzzt/oz be/ore)
tr Up ro 1,500 sq ft - $130
D 2,501 to 3,500 sq ft - $260
l Over 4,500 sq ft $325 plus $65 for each additional
1.000 sq. ft. orpor-rion thereo0).
tUe za' Mz/n:Fam ///,Due//thg (A z wcro i Oz/y/
tr Duplex Apartment $260
A Three.orm.orgyuhi.familyunits.-$l30perbuildingplrt9.55_p-.runit:($1,30x# qf buildings) +(g65x# of units)D f,xisting Residence, Modular, Manufacturcd oiMobile Ao-es, "branch circuit,-up to the maximum of the_c_o_rresp_"lqg sq. ft. of the building (Ses + (Srrir * U*"Jfr .i-"ld)j-!CenbalHeating/CoolingSystems:$65\J{henNoTpal1ofnewreside".iil"'rrv@'r'noadd^itional
Viiring
_ o ___spas, Frot Tubs, and swimming pools: $65 fee foreach trip to inspect?zmps - Watet; Imgztzb 4 .fe rzge (ezcb m o to y'
! $65 up to 25HP n$95 - 26to20OW n$130 over20O Hp
MISCELLANEOUS
tr Tempolary Constorrction Seruices ONLY: 200 amp or less, one location (for a period nor to exceed 1 year) - $55! Temporary Amusementr $65 fee plus $10 per ride, concession or geneftrtor
D Irrigation Machine: $65 for centerpivot phx $10 pertower of drive motor
n Technical Service: $65 perhour
n Plan Check $65 perhow
! Requested Inspection: $65
:Li"i"8 Spac.e - space within a dyelling unit intended for human habitation which mayreasonablybg utilized for sleeping eating, cooking,bathing, y{5tS' recreation, and sanitation pwposes. An unfinished basemenr is considered pari of the li"i"g rp;;..
<x 1.>r)3* 3c*,-)Contractor License number &Date
tr 1,501 to 2,500 sq ft - $195
D 3,501 to 4,500 sq ft - $325
1,000 sq ft. orponion thereof ($325 + ($65 x # of addfuional
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15 N. ilr' E., Rexburg, Id gJ44O CIfy ot Rerburg
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REXBUITG(\
lar, ra,rr Lrz,:ir | ..rp,r,,tltr
SiHEtl?H5 * perrnid
Vac r Me te r Qr^rarrtity:++rtti".+....Va8 r Mec r Sizs:
rd 001/001
Rerytudl//Plumbfug!
Plumbing Conractor's Narnc Business Narnc
Addrsrs ciqi
GrrPhone QA QAZI^ lZbS Brsiness Phoni () Sa",ta
F,(Email
{^c-o-nry-R.g+/IND-r.JsTRrAL) Totar cost of prumbing sys.m (c,rlcna ^-"*fr
rol fcciJizlfi nenlioacd cbart2tn oa r[u 167ny).
unl oll platrbia,g isttu/brien.r
n _UP to $10,000 {rotd cosr of sJorern x 0.02) + 60 - g
c Betrcen $10,001- $r0o,o0o ( (roralccr o{ qrn.m - ro,lroQ) x oor) + $260 - $o orcr sr00,0or 1(.o,"t.*, oG._lloffiJ x o,obs) iii,rgo - sRESIDENTIAL
i{ezr 'fubgk fionlv &eltleg, tbc/adtag a// huitliags e&b wiag bci,tg corut tr.l€d oil ctttr pmprtv 1.uted aa tttbg ,Fv€.,sce dq?aizbn fub*/
o Up rc 1,500 sq ft - $130 D 1,501 to 2,500 sq fi - $t95o 2,501 to 3,5@ sg fr - $2q0 rj f ,SO t ro +,;OO ,q'ft - $ZSD ovcr 4,500 sq fr 5325 ph,' 555 for each additlonal [,0@ sq ft, or ponion rliereof (drrs * ($65 x Lof addi,rional1CI00 sq, ft. orgerligp the'Rofl).
rVe t Mxl*fan tj, Dae/l)ry /Co nowni Ozl)
D Duphx Apanmcnt 5250
5" H:::mf*:-Y,'*":Ill'"rl**!pry*r^p.rsr 1; 8.!d"qr;;iJ;iil"a-*#.Tffi"'ffiffiI'J[Tir?.H,.i xi
sq.ft.of drcbuilding($65 +(stAv/ of finrsd) r r-'
o C'rey VaterSystems: $lJO
n taum Sprinkler/Backlloq, Devics $65
l,;) Modular, Maoufacnrred or Mobilc Honcs: $65 for sewrr and u.ater stub conncctiqrpo Multipulpose Fire sprinklerand Domestic vaerSupply syscmr $6; f* ; t;rsprinkbrhcd srhichcvcrrs grEatcr
.fcwr# Water
o $18 Seutr Lirrc oSJS varer Linc n$65 Scunr & Valen if inspcccd ar rhc srap drncD $65 senar rurnarourd undcr horxc (ctr.rngc from scptic to ciq) ' - --- - - -
MTSCETLAT{EOUS
o Plen Chech $65 pcr hour
o Tecbnical Senice: $65 perhor.rr
n Gas Lincr $55
o VetcrHercrRcplaccment 565
n Requcstcdlnspection:S55
il Hydrooic Hcating: 365 + ($10 x,f of rnaniloftts/zones)
:Til:: ttr;-'T_:P:-dr:Tf-,^t::idcd f:rhyaf habirerion -th *If*orlubtybc un'lizcd for steeping, earins cooking,b"truog, rashing, tcnnion, end saniricion purporcs. tui unfinthcd u*"or"nr;r.-JJil;;;;;,il.'*U",og rp....
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Liccnscd (bnrnctor Ljccnse numbcr & Erp. detc Der.
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PhoneNo' Ll03 - 77@3
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lnspection tvP" F n'l*U-
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Req. BY
Project
Address
Inspectiur TYPe
permitNo. lL el62
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cAPPROVED y'prseppno"l.
C C.O. (FINAL) CNOTAPPLICABLE
fl FINAL
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ACTION REQUIRED:
lnsPector
Rec't Acknowledged
CITY OF REXBURG'
White - OfFrce CoPY
12 North Center' Rexburg' Idaho 83440
Pink - lnsPector's CoPY
Yellow - Job CoPY
APPROVEDDWGS
NSPECTED ITEMS C(
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BUSIN OCCUPANCY INSPE TICKET
tr Bldg. tr q D Elect. S Mech' C Fire
Inspection Request: Rec'd BY out" t-lb-l?-
67 -tlo{o
Req. BY Phone No'
PermitNo'*p,t
Project 'ianer P/t2'l
Address
Inspection TYPe
Day lTime Req'
Inspector's RePort Res.n Comm.
INSPECTED ITEMS CONFORM TO APPROVED DWGS trY DN EN/A
INSPECTOR'S ACTION
E FINAL
D DID NOT INSPECT
ACTION REQUIRED:
Rec't Acknowledged
CITY OF REXBURG, l'2 North Center' Rexburg' Idaho 83440
white - offrce copy y.Iow - Job copy pink - lnspector's copy
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firr*ou"o c DISAPPR''ED
fIC.O.(FINAL) fINOTAPPLICABLE
INSPECTION TICKETO
Inspecfion Reguest: Rec, drBfReq Bv Artue /('f,a a4honeNo 7n 1 ?-
"ut"' pennir *offiNua /rn'-
lnspection Type
Day /Time Req.
Bldg. O ptumb.[,,m
Inspector's Report .{nrr.
INSPECTED TCU
'NSPgroR'So*,o, A:E6r*Re*Es- firrorr^o(ffi.DC.O, (F'NAL) NNOf APPLICABLE
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ACTtoN REQUTRED:
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Rec'l Aclnowledged
lt4rdo.qtrct coDvF.F,F.C@3 Y€flo* . Joe Cop!Pf* . h*enAoo., Copy
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Inspection Reguest:
Req. By
Prujecl
Address_ Strj
lnspeclion Type
Day /Time Req.
Inspector's Reporf
INSPECTED,
INSPECTOR'S ACTION Dv Dt{ oN/A
6ppnoveo
flc.o. (FTNAL) oDISAPPR'VED
ACTI'NREeuTRED: oNffiAPPLICABLE DFIT{AL
DOIONOTTNSPECT
Rec'l Acknowfcdeed
tthl..Oflicc CoDF.FtR.c@3 lblff . &b Cop,Prr. fr*rCcf Coer
SrqrroNrrcKEr
O Mech. Olnspection Reguest:
Reg. By
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Address
Inspection Type
Da/ /Time psg.
Inspector's Report F
TNSPEECTE
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O rNsPECrroN rrcxna
n BHg. O Fhmb. I Mech" f} Fire
Inspction Request: Rec'd By
'Lk,"ov"r-' Datc o f r,1 l,r*-
Req. By Phone No.
-7 o'i* Y(a5<-'
Project
Address
Inspction Type
Day ffime Req.
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INSPECTED ITEMS CONFORM TO APPROVED DWGS []Y Dr.{ fl N/A
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ion Requcst: Rec'd By '33L:!1.{/}-Date fu - lt- I.}
phone yo. t/t:_77U,.5 .
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Dav /Time Reo. b '
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INSPECTOR'S ACNON
NAPPROVED
D C O. (FINAL)
ACTTON REQUIRED:
'fi,rorr*o','
N NOTAPPLICABLE D DID NOT INSPECT
Signed
Rec'l Ackiowlcdged
Wt*tr - oltc Copy
F.Frf,.C003
}blo{, .Job CoOy n* - fcprdor.i Copy
"e4\d5 e**r*txg
Receipt Number:levelopment
D. 83440
208) 359-3022
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12-0237 04t2512012
12-0237 0U25t2012
12-0237 04t25t2012
12-0237 04t2512012
12-0237 0412512012
12-0237 04t25t2012
12-0237 0412512012
12-0237 04t25t2012
Plumbing Permit Fee $65.00
Total:
$65.00
nit Fee
i;i'i
lewer
Hookup FeeMater
Mechanical Residential Fixtures
Park lmpact Fee
Permit - Electrical
Plan Gheck Fee
Police lmpact Fee
Residential Plumbing Permit Fee
Street lmpact Fee
$1,318.55
$69.43
$697.00
$637.00
$6s.00
$4s8.8s
$65.00
$131.86
$55.26
$6s.00
$691.66
$65.00
1200152
1200152
1200152
1200152
1200152
1200152
1200152
1200152
1200152
1200152
'|.200152
CREDIT CARD $ 65.00
Total:$65.00
genpmtneceipts Page 1 of 1
velopment O Receipt Number:
). 83440
08) 359-3022[iiY ilr ritrBi"]RG
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IrATE: [4]!:5,j11
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HtF N0:11-1I
41 BF titcH. ttFHIT Ui,ttrtFt t
4: trr' ti-E{:T. FEfti{IT 'l ! i{I
43 FF F'.l.ui'lB. plR'r'tIT UNljtt:
44 FIRE tit-u. Ii'lPAlT tEts
45 StldtFl IAFITAI [t'llHili]Tif
4i IdATEII IAFITAL CfiH}.IEITIfi
4? t'Aftii5 .ijtv' Il'tl'ACT F[t$
4e FILIIt-!tUtLfiFl'tE]lT Ii{Fil
4? STHtt.T lrtti. lHFAri I'Lb-$
5tI BF IUTL. FTR}ITTS Uil!:ITTt
51 BF lUiL trtF FlAi'lfHEtlii:t
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FATi.ITNT
T.H*NDT
FERI'{IT li 11 [[15:
sidential Fixtures "/
ical \/
e/
rmbing Permit Fee
)wer
ater
e
iee
ee
: Fee
6:.il!
ri5 ' fil
i5,[[
eF.43
t?? . fiil
tI?.ill
45S , B5
55.:*
,!?1,66
I 1:i1fi '51
131 "s*
4 1:i4,61
4 1i54 .,51'il
"rfi
$65.00
$65.00
$131.86
$6s.00
$69.43
$697.00
$637.00
$458.85
$5s.26
$691.66
$1,318.55
Total:
$6s.00
$65.00
$131.86
$65.00
$69.43
$697.00
$637.00
$458.85
$55.26
$691.66
$1,318.55
$0.00
$o.oo
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.oo
$0.00
$4,254.61
THAi'lti YoU Al'lir HAUI |l NICI trAY
Total:
ffi
$ 4,254.61
$4,254.61
genpmtrreceipts Page 1 of 1